Geisel School of Medicine, Dartmouth College, Center for Technology and Behavioral Health, 46 Centerra Parkway, Suite 315, Lebanon, NH, USA.
Advocates for Human Potential, Inc., Corporate Office, 490-B Boston Post Road, Sudbury, MA, USA.
Drug Alcohol Depend. 2021 Oct 1;227:108939. doi: 10.1016/j.drugalcdep.2021.108939. Epub 2021 Jul 30.
Cannabis use is increasingly common among pregnant women despite concern that it may be linked to adverse maternal and infant outcomes. Determining whether variables associated with cannabis use predict whether women continue or quit using during pregnancy may inform strategies to reduce prenatal use.
Pregnant women who regularly used cannabis before pregnancy (n = 296) were recruited via Facebook. After finding out they were pregnant, 41 % reported quitting, 13 % quit then relapsed, 32 % reduced use, and 15 % continued use at the same rate. Differences among these four cannabis use status groups (quit, relapsed, reduced, continued) in sociodemographics, cannabis use, cigarette use, perceived risk/benefit, delay discounting, and communications about cannabis with their doctor were assessed.
Compared to those who quit, continuing use during pregnancy was associated with being unemployed (Relative Risk (RR) = .32, 95 %CI [.13, .78]), using cigarettes pre-pregnancy (RR = 3.43, 95 %CI [1.32, 8.94]), being in an earlier trimester (RR = 4.38, 95 %CI [1.18, 16.23]), less perceived risk (RR = .79, 95 %CI [.74, .85]), and more days per week of use pre-pregnancy (RR = .10, 95 %CI [.01, .84]). Unintended pregnancy, shorter time to cannabis use after waking pre-pregnancy, using cannabis more times per day pre-pregnancy, and greater perceived benefits of use had significant bivariate associations with continued use during pregnancy, but did not retain significance in a multinomial model.
Identification of these correlates provides potential targets for prevention of or intervention for prenatal cannabis use. However, much more research is needed to understand prenatal cannabis use and its effects in order to better educate women and healthcare providers, and to design optimal public health strategies.
尽管担心大麻使用可能与母婴不良结局有关，但孕妇中大麻使用的情况仍越来越普遍。确定与大麻使用相关的变量是否可以预测女性在怀孕期间是否继续或停止使用，可能有助于制定减少产前使用的策略。
通过 Facebook 招募了 296 名在怀孕前经常使用大麻的孕妇。得知自己怀孕后，41%的人报告说已经戒断，13%的人戒断后又复发，32%的人减少了使用量，15%的人以同样的速度继续使用。评估这四个大麻使用状况组（戒断、复发、减少、继续）在社会人口统计学、大麻使用、吸烟、感知风险/益处、延迟折扣和与医生沟通大麻方面的差异。
与戒断者相比，怀孕期间继续使用大麻与失业（相对风险（RR）=0.32，95%置信区间[0.13，0.78]）、怀孕前吸烟（RR=3.43，95%置信区间[1.32，8.94]）、处于早期妊娠（RR=4.38，95%置信区间[1.18，16.23]）、感知风险较低（RR=0.79，95%置信区间[0.74，0.85]）和怀孕前每周使用天数增加（RR=0.10，95%置信区间[0.01，0.84]）有关。意外怀孕、怀孕前醒来后使用大麻的时间更短、怀孕前每天使用大麻的次数更多以及使用大麻的感知益处更大，与怀孕期间继续使用大麻有显著的双变量相关性，但在多变量模型中没有保留意义。
确定这些相关性为预防或干预产前大麻使用提供了潜在的目标。然而，为了更好地教育妇女和医疗保健提供者，并设计最佳的公共卫生策略，我们需要进行更多的研究来了解产前大麻使用及其影响。
